A-Z Health Topics

Reducing Risks When You Have Heart Disease

People with heart disease are at increased risk for suffering
heart attacks
or
sudden cardiac death. But there is evidence that risk factor modification can help people with
coronary artery disease
(CAD). Taking steps like lowering your blood pressure and cholesterol can improve survival and quality of life if you have heart disease. Here are some therapies to help protect your heart.

Guidelines

The American Heart Association and American College of Cardiology jointly released guidelines on secondary prevention for people with cardiovascular disease. Their recommendations reflect data gleaned from large scale clinical trials that have identified which preventive therapies work best. Check to see which advice you are already using correctly, and which you may want to discuss with your doctor.

Remember that high blood pressure does not have symptoms, so you will not know you have it or if it changes. Consider buying a reliable home monitoring device so you can check your blood pressure on a regular basis.

Cholesterol

Goals

You should have a blood test called a fasting lipid profile. Desirable ranges of lipid levels are:

LDL (bad) cholesterol less than 100 milligrams per deciliter (mg/dL).

Non-HDL cholesterol (combination of bad cholesterol) less than 130 mg/dL if triglycerides are greater than 200 mg/dL.

Your doctor will evaluate your lipid levels and help you determine what is desirable for you.

Weight

Desirable waist measurements are no more than 40 inches (102 centimeters) for men, and no more than 35 inches (89 centimeters) for women.

Advice

If your weight is not in the target range, start weight management and medically supervised physical activity programs.

Diabetes

Goals

If you have diabetes:

Have your HbA1c tested regularly. The HbA1c test provides information about your diabetes management over the past few months.

Aim for HbA1c below 7%.

Advice

If blood sugar is too high, intensify therapy to control blood sugar.

Address other risks, such as weight, activity level, blood pressure, and cholesterol.

Drug Therapy

Goal

Ask your doctor to evaluate your need for preventive drugs.

Advice

Aspirin is recommended for most people with CAD. If you cannot take aspirin, your doctor may recommend another type of blood thinner.

If you are at high risk or have had a
heart attack, your doctor may recommend other medications, such as ACE inhibitors, beta-blockers, and cholesterol-lowering medication.

Other Recommendations

Advice

It is important that you take steps to stay healthy, like getting a yearly
flu shot.

You should also talk to your doctor about your mental health, which can impact your overall health. Tell your doctor if are feeling
depressed
or
anxious
or if you are having
problems sleeping.

RESOURCES

American Heart Association
http://www.heart.org

National Heart, Lung, and Blood Institute
http://www.nhlbi.nih.gov

CANADIAN RESOURCES

Canadian Cardiovascular Society
http://www.ccs.ca

Heart and Stroke Foundation of Canada
http://www.heartandstroke.com

References

Antman EM, Hand M, Armstrong PW, et al. 2007 Focused update of the ACC/AHA 2004 guidelines for the management of patients with ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2008;117(2):296-329.

Executive summary of the third report of the National Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III).
JAMA. 2001;285:2486-2497.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.